Mandatory Health Insurance Rules
Step 5 - Medical Expense Settlement & Temporary Stay
Previous sections covered healthcare insurance systems and the reimbursement of medical expenses for employees insured in one country but residing in another, and the crucial role of social security treaties in these arrangements.
This section will explore scenarios where employees and their dependent family members require medical care during short stays outside their country of insurance and residence.
Within the EU/EEA/Swiss region
Employees with statutory insurance in the EU/EEA/Swiss region can access necessary medical care during a short stay in another member state by presenting their European Health Insurance Card (EHIC). This benefit also extends to any co-insured family members.
In Bilateral Treaty situations
Some bilateral social security treaties allow individuals on short-term assignments to access necessary medical care, with costs covered by their health insurance in their country of Insurance.
When the treaty does not offer this coverage, the employee must pay medical expenses directly to the local healthcare provider. Supplementary international (travel) insurance can help bridge any gaps between existing insurance coverage and medical expenses incurred abroad.
In Third-country situations
In countries without such treaties, the employee typically pays medical expenses directly to the local healthcare provider. They then need to file a claim for reimbursement with their health insurer and/or travel insurer. Some healthcare and travel insurers offer direct payment to providers, frequently facilitated by an emergency assistance center.
Elaboration
The European Health Insurance Card - EHIC
The EHIC proves that the insured person is covered in another member state, allowing them to receive medical care at the expense of their health insurance in that state, according to the rates and conditions of their home country's insurance system.
Caution
Please note the EHIC has the following key limitations:
It is not a substitute for travel insurance; it does not cover private healthcare, repatriation, or lost/stolen property.
Tips & Best Practices
Supplementary international (travel) insurance
Supplementary insurance can help bridge any gaps between existing insurance coverage and medical expenses incurred abroad. Some insures also offer direct payment to providers, frequently facilitated by an emergency assistance center.